Life & Work

I have gallstones, what next?

gall

PHOTO | FILE

After several months of having on and off abdominal pain, I went to my GP who recommended I go for an ultrasound scan. The scan showed that I have gallstones. My GP suggested that I should have them removed. Is that really necessary? Are there other treatment options? Can they resolve on their own?

Gall stones are one of the most common problems seen by Kenyan surgeons today. Although they tend to be more common in middle aged women, men have also been found to have them. They can also occur in people of all ages.

Being overweight seems to predispose one to develop these stones. In addition, worm infestation (especially the variety that invades the liver area), sickle cell disease and other blood abnormalities put one at a higher risk of getting gall stones.

Losing weight

Other things that put you at risk of getting gall stones include being pregnant, eating a high-fat and low-fibre diet, having a family history of gallstones, having diabetes, losing weight very quickly, taking some cholesterol-lowering medications and taking hormonal drugs that contain oestrogen.

Most people with gall stones do not get symptoms from them. A few, however, get on and off pain on the right side of their belly. This pain is usually dull in nature and can be quite severe.

Often it resolves after a few hours on its’ own.

This pain is thought to occur as the gall bladder attempts to pass out some of the stones inside it. In some cases, the gall bladder can get infected causing you to have severe pain, fever, nausea and vomiting.

Best treatment

Often you require antibiotics to deal with this. The gall bladder and liver have a common drainage system and sometimes a stone can block this system causing pain and even jaundice (yellow eyes and skin).

Generally speaking, gall stones do not resolve on their own but if they are not symptomatic, they often can be left alone. However, if they are a source of pain and infection, they must come out.

Currently, the best treatment option for gall stones is surgery. Sometimes, doctors use medication to try and dissolve them but they almost always recur.

They also devised methods involving shock waves delivered to the gall bladder in an attempt to break them down but they also always recur.

For this reason, non-surgical options are strictly reserved for people in whom surgery is too risky.

Surgery for gall stones is currently minimally invasive (laparoscopic or ‘pinhole’ surgery) and is carried out as a day case. Often the recovery in this case is much faster and the final outcome is generally good.

Remember, the gallbladder is not an essential organ, which means a person can live normally without a gallbladder.
Its main function is to store a special digestive fluid known as bile once it has been manufactured by the liver.

Once the gallbladder is removed, bile flows out of the liver directly into the intestines, instead of being stored in the gallbladder.
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I am 46- years- old and have been living with gallstones for several years now. Although they cause me on and off pain, I am not willing to have surgery. What dietary changes should I make to deal with them? Does alcohol contribute to their development?

There is no special ‘gall stone diet’. However, when it comes to eating plans for people with gall stones, it may be helpful to have a high fibre low fat diet.

Try and get in lots of fruits, whole grain cereal and vegetables and reduce on foods that are rich in ‘bad’ cholesterol (like fatty meat). Where possible, opt for lean meat, poultry and fish and low-fat dairy products.

Eat regular small meals and do not skip meals. Skipping meals or fasting can increase the risk of gallstones.

Try and maintain a healthy weight. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose about 0.5 to one kilogramme a week.

Work to achieve a healthy weight by reducing the amount of calories you eat and increasing the amount of physical activity (exercise) you get. Remember, reducing calories does not mean you starve yourself, it simply means you make better food choices.

Alcohol on its own does not cause gall stones. However, if taken in excess it can lead to liver damage (cirrhosis) which can put you at a higher risk of getting gall stones. For this reason, it is crucial to limit the amount of alcohol you take per week and avoid binge drinking.

It is important to understand that changing your diet will not cure your gall stones. Once you have them, they are often there for life. If they are symptomatic, it is often best to have them removed.

DR NG’ANG’A will answer your questions on lifestyle and other diseases and medical issues for both children and adults.

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